HeartWare Ventricular Assist Device as Bridge to Transplant in Children and Adolescents

Abstract

Limited options do exist for mechanical circulatory support as a bridge to transplantation in the pediatric population. This is especially true when it comes to intracorporeal technologies. We describe our successful experience with the use of HeartWare ventricular assist devices (HeartWare, Inc., Framingham, MA, USA) in three patients <16 years of age, as a successful and feasible bridge to transplant in patients weighing greater than 20 kg.

Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: A report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS)

“…6 Although the current generation of continuousflow (CF) devices has not been specifically tested or approved in children, many pediatric centers have utilized these devices in recent years. 7,8 Initial reports have suggested a high rates of survival to transplant with a favorable adverse event profile 7,8 ; however, there are very few data on the overall use or outcomes in this population. We aimed to describe the overall use and outcomes of CF VADs in pediatric patients and test the hypothesis that pediatric patients supported with CF VADs have comparable outcomes to those of adults supported with CF VADs.…”

Outpatient Management of Intra-Corporeal Left Ventricular Assist Device System in Children: A Multi-Center Experience

“…A total of 14 centers were contacted, with 9 centers, contributing data retrospectively. From 2011 to 2013, 12 pediatric patients (7 females), mean aged 11.9 AE 2.3 years (range [8][9][10][11][12][13][14][15], mean weight 43 AE 19 kg (range 18-81), mean body surface area 1.3 AE 0.3 m 2 (range 0.76-1.96) were identified. Diagnosis included: dilated cardiomyopathy (CMP) (n ¼ 5), noncompaction CMP (n ¼ 4), toxic CMP (n ¼ 2) and viral CMP (n ¼ 1).…”

Favorable Waitlist and Posttransplant Outcomes in Children and Adolescent Patients Supported With Durable Continuous-Flow Ventricular Assist Devices

“…Early outcomes in this subgroup of children were comparable to those in similarly sized adults (17). Limits are now being pushed, with subsequent case reports and series showing that CFVAD implantation is feasible (11,(18)(19)(20) in smaller children with BSA as low as 0.7 m 2 (11,21). With increasing mismatch between patient size and device, concerns arise about anatomical fit and excessive flow for patient need.…”